Lung maturational agents and surfactant treatments: are they complementary in preterm infants?

Maternal corticosteroid treatments are used by many obstetric services in selected cases of preterm labor to induce lung maturation. This maturational strategy, however, has not received universal acceptance and often is used without much enthusiasm because such treatments do not prevent respiratory distress syndrome (RDS) in many infants. This article develops the thesis that the effects of maternal corticosteroid treatments are not primarily on the surfactant system, but rather on other aspects of lung development. The question posed by the title has not been answered by published clinical trials, but a growing body of experimental research with animal models indicates that strategies to induce lung maturation and to treat infants with surfactant will be complementary. An added benefit of the use of lung maturational agents should be the induction of maturational responses in other organ systems in the fetus.